Survey of Impression Materials and Techniques Used in Fixed Prosthodontics among Nepalese Dentists

There is variation in fixed prosthodontics practice and many studies have concluded that clinicians definitely deviate from the recommended clinical protocols. If this happens during treatment with fixed prosthesis, the quality of fixed prostheses is compromised which affects it’s long term survival. Therefore, the aim of this study was to evaluate the use of impression materials and techniques in fixed prosthodontics among Nepalese dentists and to compare the findings on the basis of educational level and years of experience. A cross-sectional, questionnaire-based online survey was done amongst the Nepalese Dentists through google forms. Data from the completed questionnaires were analysed using the SPSS version 16. All statistical analyses were carried out at a significance level of P < 0.05. Out of 129 participants, 68 (52.7%) dentists often made diagnostic impression for fabrication of study cast. 85(65.9%) dentists used Addition silicone, 11(8.5%) used Condensation silicone and 33(25.6%) used Alginate for final impression making. Most commonly used elastomeric impression technique was Putty Wash single stage (56.2%), 40.7% used Putty Wash two stage, 3.1% used Single mix (Monophase) technique. Regarding retraction cord, 63.5% of dentists used Plain gingival retraction cord and 35.7% of dentists used Chemical impregnated retraction cord. Conclusion: The study found that most of the responses on use of impression materials and techniques were significantly associated with the level of education and clinical experience.

Microbial Differences Between Progressive and Stable Peri-Implantitis

Peri-implantitis has a polymicrobial etiology and is a major cause of dental implant loss. Various clinical protocols for its prevention and treatment have been proposed; however, some cases show a rapid progression with non-resolving clinical symptoms. To clear a means of differentiating between such cases, the implants with peri-implantitis in this study were categorized as the progressive group and the stable group and that two kinds of samples were obtained from the same subjects (n= 20). The microbiome was analyzed through pyrosequencing of the 16S rRNA gene. The stable group was found to have a diverse bacterial flora when compared to the progressive group. Porphyomonas, Fusobacterium, Treponema, Tannerella, and other periodontal pathogens were abundant in the progressive group, while Lactobacillales and Bifidobacterium were abundant in the stable group. These findings suggest that the bacterial flora dominated by these periodontal pathogens caused disease progression, while the bacterial flora dominated by Lactobacillales and Bifidobacterium stabilized the disease. Thus, the disease progression and stability of peri-implantitis may be influenced by the bacterial flora of the peri-implant pocket.

Globalized research

The current issue of IJHDR begins by a now classical dilemma relative to the high dilutions: if they lack biological effects, how might they cause adverse effects? The plausibility of the implausible is once again the subject of a letter addressed to this Editor. The present issue further features three articles from Indian authors, which somehow makes the occasion special, and worthy of reflection: what is going on in Indian homeopathy? As it is known, India has always played a significant role in the homeopathic stage by contributing with original clinical protocols and approaches. More recently, India has shown the world unexpected scientific features of the high dilutions. The natural and cultural diversity of India seems to influence the research it conducts, which ranges from physicochemical and biological studies performed in research centers and universities to clinical trials conducted in hospitals, in addition to a major concern with education. India has thus become one of the main centers concerned with the scientific side of homeopathy, which is further attested by the organization of, and participation in major scientific meetings like the LMHI congress of 2011, GIRI meetings, and the latest HRI conference, and publication in IJHDR and other scientific journals. As an example of the multiple interests of homeopathic research in India, one article in this issue of IJHDR addresses a fundamental research problem, another the patients’ satisfaction, and the third the perspective of undergraduates on the teaching of homeopathy. This same movement observed in India has been observed in other countries like Brazil and Russia among others, following many European countries, making possible and feasible the existence of an international scientific network connecting the various groups devoted to HD research across the world. IJHDR is proud to participate on this endeavor!

Awareness, perception and acceptability of digital physiotherapy intervention among Malaysian physiotherapist

Digital health intervention (DHI) can solve the patient's problem, such as geographical inaccessibility, delayed provision of care, low-level adherence to clinical protocols, and financial burden. DHI does not necessary to work as a substitution for a functioning health system but helps strengthen its function. Therefore, this study aimed to determine the awareness, perception, and acceptability of digital physiotherapy intervention (DPI) among Malaysian physiotherapists. A total of 209 practicing physiotherapists representing all the regions in Malaysia participated in this online self-reported questionnaire, including demographics profile, continuous professional development, awareness, perception and acceptability of DPI. Analyzed the collected data to determine the knowledge of DPI by using descriptive statistical methods. A 75.1% of the Malaysian physiotherapist aware of digital physiotherapy intervention, 69.38% perceived it reduces the cost for face to face, reduce the time for traveling 47.85%, improve adherence to exercises 42.58%, 78% of them agree with the DPI and 75.1% of them accepted to recommend the digital tools to their patient. Malaysian physiotherapists are aware, agree and recommend the digital physiotherapy intervention to their treatment plan. However, it should still raise awareness about digital physiotherapy intervention to lead them to the future. Developing new digital tools, utilization, and overcoming the various healthcare institutions' low acceptability considering the cost, conventional interventions, and time-consuming should be strategized in Malaysia.

Dual-energy computed tomography: Survey results on current uses and barriers to further implementation

Objective: To gauge the current availability of dual-energy computed tomography (DECT) scanners in the UK, establish available technologies, look broadly at current clinical uses in adults and paediatrics, and identify barriers to implementation and potential ways to increase use. Methods: A survey was distributed amongst 10 radiology departments and shared on two national professional co-operation mail bases; the survey ran from 20th July to 9th December 2020. It explored current DECT utilisation in adults and paediatrics as well as barriers to use and suggestions to overcome those barriers. Results: The survey demonstrated DECT availability on 39 (40%) of the 98 CT scanners, but there was limited clinical use in adults and paediatrics. Eighteen (72%) of the 25 respondents had access to at least one DECT scanner, with 14 (56%) having adult DECT protocols in clinical use; <10% head examinations and <50% for other anatomical areas. Only two (8%) respondents had DECT paediatric protocols in clinical use; <10% examinations for all anatomical areas. The main barriers to implementation identified were lack of experience with DECT (8 (44%) users (adult) and 10 (56%) users (paediatric)) and no clinical protocols available (6 (33%) users (adult and paediatric)). Understanding DECT benefits and establishing suitable protocols were the most popular suggestions for increased implementation (10 (40%) of 25 respondents). Conclusion: DECT scanners are available, but clinical use is limited for both adults and paediatrics. The main barriers identified were lack of experience with DECT and the availability of suitable protocols. Further work identified to help implementation included better education on the benefits of DECT, provision of clinical protocols and ensuring a multidisciplinary approach. Advances in knowledge: Barriers to implementation of clinical DECT protocols were identified, together with potential solutions to overcome these and enable further implementation.

Protocolos clínicos em Hipomineralização Molar Incisivo (HMI): revisão integrativa da literatura

A hipomineralização molar-incisivo (HMI) é definida como um defeito qualitativo do esmalte caracterizada pelo aparecimento de lesões opacas de coloração branca, amarela ou marrom, que variam em tamanho e apresentam rápida progressão de lesões de cárie e hipersensibilidade, que afeta os molares e os incisivos. As modalidades de tratamento para os dentes afetados com essa condição são extensas, variam de acordo com o grau e localização da HMI tornando-se um desafio para os cirurgiões dentistas. O objetivo desse estudo é descrever os protocolos clínicos e os planos de cuidados para pessoas com hipomineralização molar-incisivo. Foi realizada uma revisão integrativa da literatura, utilizando as chaves de busca “Molar incisor hypomineralization” “Clinical Protocols” “Children” “Treatment”, com o operador booleano “and”, por meio da qual foram selecionados a partir dos critérios de elegibilidade propostos na estratégia PRISMA ScR, 10 artigos para análise qualitativa, nas bases de dados SciELO, Pubmed e BVs. Percebeu-se as modalidades de tratamento para os dentes afetados por HMI variam amplamente, dependendo da gravidade, e da presença de fatores complicadores, como hipersensibilidade, higiene oral e cooperação do paciente. Conclui-se, portanto, atualmente, não há consenso sobre a superioridade de tratamento de dentes afetados por hipomineralização molar-incisivo (MIH), já que se tem o desafio das as fraturas pós eruptivas, hipersensibilidade dentinária e a dificuldade de adesão dentinária. Mais estudos são necessários para que este agravo comum na contemporaneidade clínica odontológica tenha de fato uma forma eficaz de ser solucionada.

Post-covid condition in adults and children

Despite the impressive progress in diagnosis and management of acute COVID-19, data regarding the consequences of this infection are just emerging. The World Health Organization has proposed the term post-COVID condition (PCC) to describe the wide range of sequelae of acute COVID-19. With more than 200 million confirmed cases of COVID-19, PCC may develop into a major problem for many years to come for the millions of COVID-19 survivors worldwide. Few studies were conducted in primary care, and very few studies have focused exclusively on children and adolescents.Objective. To review existing data on PCC. Analysis of manuscripts published in peer-reviewed journals and clinical protocols. PCC is characterized by a wide range of systemic, cardio-pulmonary, gastrointestinal, neurological, and psychosocial symptoms.Conclusion. Although PCC prevalence is difficult to estimate due to methodological limitations of the existing studies, there is no doubt that this problem is a significant healthcare burden. There is a need for further observational and interventional studies to establish optimal PCC prevention and management strategies.

Porphyrin Based 2D-MOF Structures as Dual-Kinetic Sorafenib Nanocarriers for Hepatoma Treatment

The existing clinical protocols of hepatoma treatment require improvement of drug efficacy that can be achieved by harnessing nanomedicine. Porphyrin-based, paddle-wheel framework (PPF) structures were obtained and tested as dual-kinetic Sorafenib (SOR) nanocarriers against hepatoma. We experimentally proved that sloughing of PPF structures combined with gradual dissolving are effective mechanisms for releasing the drug from the nanocarrier. By controlling the PPF degradation and size of adsorbed SOR deposits, we were able to augment SOR anticancer effects, both in vitro and in vivo, due to the dual kinetic behavior of SOR@PPF. Obtained drug delivery systems with slow and fast release of SOR influenced effectively, although in a different way, the cancer cells proliferation (reflected with EC50 and ERK 1/2 phosphorylation level). The in vivo studies proved that fast-released SOR@PPF reduces the tumor size considerably, while the slow-released SOR@PPF much better prevents from lymph nodes involvement and distant metastases.

Surgical treatment of complicated duodenal ulcers with different variants of their localization

Purpose: To analyze and highlight the most effective methods of surgical treatment of complicated duodenal ulcer (DU) depending on its location. Material and methods. 86 patients underwent surgery for complicated combined pyloroduodenal ulcers. All patients with signs of gastrointestinal bleeding and perforation were examined according to clinical protocols. Patients were operated on by various surgical techniques depending on the location of DU. Further the analysis of different methods of surgical treatment of the pathology under study at its various localizations was carried out. Results. It has been established that in complicated combined pyloroduodenal ulcers with localization in the pyloric canal antrumectomy is the method of priority. If duodenum ulcer is complicated by bleeding, excision with pyloroplasty is the method of priority. Suture ulceration with pyloroplasty can be considered as an alternative method of treatment. It has been verified that in complicated duodenal ulcers, exteriorization and suturing of the ulcer have the lowest efficiency. The most frequently used method of duodenal ulcers of any localization treatment was excision of the ulcer with pyloroplasty. 6 (41.8 ± 0.053%).patients had been operated on by this method. In the second place in terms of universality was ulcer’s suturing with pyloroplasty - 22 patients or (25.5 ± 0.047%). The third was the method of exteriorization and suturing of ulcers, which accounted for 10 patients (11.6 ± 0.034%).

Clinical Policies and Procedures for Critical Care Transport during a Respiratory Pandemic

The severe acute respiratory syndrome coronavirus disease-2 (SARS-CoV-2) pandemic of 2020-2021 created unprecedented challenges for clinicians in critical care transport (CCT). These CCT services had to rapidly adjust their clinical approaches to evolving patient demographics, a preponderance of respiratory failure, and transport utilization stratagem. Organizations had to develop and implement new protocols and guidelines in rapid succession, often without the education and training that would have been involved pre-coronavirus disease 2019 (COVID-19). These changes were complicated by the need to protect crew members as well as to optimize patient care. Clinical initiatives included developing an awake proning transport protocol and a protocol to transport intubated proned patients. One service developed a protocol for helmet ventilation to minimize aerosolization risks for patients on noninvasive positive pressure ventilation (NIPPV). While these clinical protocols were developed specifically for COVID-19, the growth in practice will enhance the care of patients with other causes of respiratory failure. Additionally, these processes will apply to future respiratory epidemics and pandemics.